Advance Care Planning, Heart Failure
Conditions
Brief summary
The study aims to develop and evaluate a web-based interactive platform (called 'My Voice') that helps to educate patients with heart failure and their caregivers about heart failure, identify their goals for end-of-life care, and share these with their caregivers and doctors.
Detailed description
The research study consists of 3 phases: 1. Usability testing - to assess the usability of 'My Voice' with patients with heart failure, their caregivers and healthcare providers, 2. Pilot testing - to test the feasibility of implementation and workflow of 'My Voice' and the survey questionnaires with a small group of participants and, 3. Randomized controlled trial- to evaluate the effectiveness of 'My Voice' with a control group who do not receive the intervention in improving patient outcomes
Interventions
OTHERMy Voice
The web intervention educates patients about their illness and supports them to make their own Advance Care Planning decisions, update these decisions frequently as their clinical condition changes, and to make the ACP process easier and more accessible. The intervention aims to shift implementation of ACP from a provider-led one-time model to a patient-led dynamic model.
Sponsors
Duke-NUS Graduate Medical School
Changi General Hospital
Singapore General Hospital
Sengkang General Hospital
National Heart Centre Singapore
Khoo Teck Puat Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- The inclusion criteria for patients are 1. Age ≥ 21 years old 2. Singaporean or Permanent Resident 3. Diagnosed with heart failure 4. Symptoms classified under NYHA class II (with an ejection fraction of less than or equal to 35%), III or IV 5. Intact cognition determined through the Abbreviated Mental Test (AMT) (for pilot testing and main RCT) 6. Ability to speak and read English, Mandarin or Malay 7. Willing to complete a web intervention 8. Easily contactable via mobile phone or landline 9. Have a permanent address in Singapore for at least the next 1 year 10. Not recruited in a previous phase of the study The inclusion criteria for caregivers are 1. Age ≥ 21 years old 2. Nominated as a healthcare spokesperson by the patient or the main decision maker for the patient (for intervention arm only) 3. Ability to speak and read English, Mandarin or Malay 4. Willing to complete a web intervention 5. Easily contactable via mobile phone or landline 6. Have a permanent address in Singapore for at least the next 1 year
Exclusion criteria
for caregivers are: a) domestic helper
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients who have ACP discussions with their treating doctor at least once during the study period | 1 year from data collection | will be assessed from medical records and survey |
| Proportion of patients who have ACP discussions with their caregivers | 1 year from data collection | will be assessed from the survey |
| Proportion of patients who prefer life-extending treatments | 1 year from data collection | will be assessed from the survey |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients with psychological distress | 1 year from data collection | will be assessed from the survey |
| Peace and acceptance scores | 1 year from data collection | will be assessed from the survey |
| Proportion of patients having decision maker | 1 year from data collection | will be assessed from the survey |
Countries
Singapore
Contacts
PRINCIPAL_INVESTIGATORChetna Malhotra
Duke-NUS Graduate Medical School
Outcome results
None listed